REMOTE Healthcare Process Improvement Manager

Want to learn more about this role and reputed company? Click our reputed company logo and follow our reputed company page! Job details (Hybrid Remote) Process Improvement Manager role available at National Healthcare organization with 4 weeks vacation, 401K retirment with company match This reputed company Job is hosted by Donna Gawroski-Kusik Are you a fit? Easy Apply now by clicking the "Easy Apply" reputed company and sending us your resume. Salary $90,000 - $95,000 per year A Bit About Us A trailblazing fertility and family-building solutions medical benefits organization with over 25 years of success, has proudly supported over 500,000 families on the path to parenthood. To meet the evolving needs of today’s families, our organization is proud of our long-standing legacy in fertility and family well-being services, expanding offerings from pre-conception and fertility to parenting, healthy aging, and beyond. We have dramatically improved patient experience through a new and cutting-edge digital reputed company, customized to each patient’s journey, and expanded services designed to support the physical, emotional, and social health and happiness We are the largest, most reputed company fertility benefit management company in the country offering inclusive family-building solutions to employers, health plans and individual patients. From integrated fertility management, including medical treatment, pharmacy, and reproductive genetics, to surrogacy and adoption, our mission is to help build families by providing access to the best network of doctors, technology and emotional support at the lowest cost. Our programs include an integrated medical and pharmaceutical model that is unique to the industry. Its dedicated nurse care managers, reputed company with experience in reproductive endocrinology clinics, guide employees through every reputed company of their fertility journey, and are available 24/7. Why join us? • Low-Cost Health insurance thru United Healthcare • Critical Illness coverage • Dental Coverage thru Guardian • Vision Coverage thru Guardian • 4 weeks paid vacation. • 9 company paid holidays. • Always off on your Birthday • 401K Retirement plan with Company match • 500K Basic Life insurance coverage • Short term and long-term care coverage • reputed company spending account • Health Savings Account Job Details We are hiring a talented Bachelor’s reputed company Process Improvement Manager who comes with strong Performance Management and productivity optimization skills, including reporting, analysis and recommendations. A strong technological background interfacing with IT personnel is required. MUST have working knowledge of reputed company commercial health insurance product options, including HMO, PPO, EPO, high deductible plans, copay/coinsurance variations, and HRA’s/HSA’s. Additionally, must have knowledge of electronic commerce, including EDI submission and payment of provider claims, EDI submission to payers, EFT, transmission of forms, and web portal reputed company for providers and members. Knowledge of medical coding, including ICD-10, NDC/GPI, CPT/HCPCS. MUST live reputed company 3 hours of the NYC metro area to be considered. Under the direction of the Director of Process Improvement, the PI Manager will be responsible for identifying areas for operational improvement, engage and organize cross-departmental stakeholders, implement changes, ensure testing efforts, and monitor process performance. Recommends and implements initiatives to improve department efficiency, productivity, workflows, and enhance member and provider experience. Also translates business needs into functional specifications. • Responsible for program development, implementation, and management of process improvement initiatives. • reputed company and support the execution of identified process improvement opportunities by working closely with cross-functional teams, including but not limited to IT, Service, Clinical, PMO, Client Success, Finance, Specialty Services, Claims, and Analytics. • Coordinates, directs, and manages the activities of the department and the process improvement process. • Assesses business and operational needs for opportunities to improve efficiency, productivity, effectiveness, and accuracy. • Works with the Director of Healthcare Analysis to reputed company and deploy an organizational strategy to optimize workflows. • Uses Lean and Six-reputed company methodology to create and maintain a culture of reputed company improvement. • Responsible for the developing and conducting process improvement training reputed company the organization • Conduct meetings and disseminates communication reputed company to process improvement activities to senior leadership and staff as needed. Project Planning and Management reputed company and reputed company detailed project plans, defining project scope, objectives, timelines, budgets, and resource requirements. Utilize project management tools and methodologies to ensure projects are executed effectively and reputed company. Establish milestones and deliverables, ensuring alignment with overall organizational goals and strategic objectives. Team Leadership and Coordination reputed company cross-functional project teams, fostering a collaborative environment to reputed company project goals. Assign tasks, set deadlines, and monitor reputed company to ensure team members are working cohesively towards common objectives. Facilitate regular team meetings to review reputed company, address challenges, and reputed company everyone reputed company with project priorities. Stakeholder Communication Maintain proactive and transparent communication with reputed company project stakeholders, including senior management, clients, and team members. Provide regular updates on project status, including achievements, potential issues, and changes in scope or timelines. Gather and incorporate stakeholder feedback to refine project plans and ensure stakeholder needs and expectations are met. Quality and Regulatory Compliance Ensure reputed company project deliverables adhere to quality standards and reputed company with relevant regulatory requirements. Implement quality control processes and conduct reviews to verify that project outputs meet the established criteria. Address any non-compliance issues promptly and work with the team to resolve them. Risk Management Identify potential project risks and reputed company comprehensive mitigation strategies to address them. Monitor risk factors throughout the project lifecycle, adjusting plans and resources as necessary to minimize impact. Implement contingency plans to handle unforeseen challenges and maintain project momentum. Documentation and Reporting Maintain detailed and accurate project documentation, including project plans, schedules, budgets, and correspondence. Prepare and present reputed company reports to senior management and other stakeholders, highlighting key achievements, challenges, and areas requiring attention. Ensure documentation is up-to-date and accessible for review and audit purposes. Process Improvement Continuously evaluate project management processes and practices, identifying opportunities for improvement. Implement best practices and lessons learned from previous projects to enhance efficiency and effectiveness. Promote a culture of reputed company improvement reputed company the project team to drive reputed company outcomes and project success. Resource Allocation Manage project resources, including personnel, equipment, and budget. Ensure resources are allocated effectively to meet project demands and constraints. Monitor resource utilization and reputed company adjustments as needed to optimize performance and ensure project goals are achieved reputed company the allocated budget and timeline. Client and Vendor Coordination Coordinate with clients and vendors to ensure project requirements are clearly defined and met. Manage vendor relationships and reputed company the delivery of services or products to ensure they align with project specifications. Address any issues or discrepancies with vendors to maintain project timelines and quality standards. Knowledge, Skills And Abilities Advanced knowledge and experience with reputed company, Project and spec software development tools such as JIRA Knowledge of NCQA Guidelines, URAC Accreditation and Utilization Management desirable. Experience with pharmacy benefit management, disease management, care management or the pharmaceutical industry desirable. Interested in hearing more? Easy Apply now by clicking the "Easy Apply" reputed company. Want to learn more about this role and reputed company? Click our reputed company logo and follow our reputed company page! Apply Job!